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Supportive Care in Cancer

, Volume 22, Issue 3, pp 847–857 | Cite as

The end-of-life phase of high-grade glioma patients: a systematic review

  • Eefje M. Sizoo
  • H. Roeline W. Pasman
  • Linda Dirven
  • Christine Marosi
  • Wolfgang Grisold
  • Günther Stockhammer
  • Jonas Egeter
  • Robin Grant
  • Susan Chang
  • Jan J. Heimans
  • Luc Deliens
  • Jaap C. Reijneveld
  • Martin J. B. TaphoornEmail author
Review Article

Abstract

Background

High-grade gliomas (HGG) are rare and incurable; yet, these neoplasms result in a disproportionate share of cancer morbidity and mortality. Treatment of HGG patients is directed not merely towards prolonging life but also towards quality of life, which becomes the major goal in the end of life (EOL). The latter has received increasing attention over the last decade.

Methods

We reviewed the literature related to the EOL phase of HGG patients from 1966 up to April 2012. Articles were retrieved from PubMed, Embase, Cinahl, PsycINFO and Cochrane database. We then selected papers for analysis using pre-determined inclusion criteria and subtracted information on the topics of interest.

Results

The search yielded 695 articles, of which 17 were classified eligible for analysis according to pre-defined inclusion criteria. Reviewed topics were symptoms and signs, quality of life and quality of dying, caregiver burden, organization and location of palliative care, supportive treatment, and EOL decision making. Nearly all identified studies were observational, with only two non-randomized intervention studies. Symptom burden is high in the EOL phase and affects the quality of life of both patient and carer. Palliative care services are more intensively used compared to other cancer patients. Cognitive deficits increase as the disease progresses, hampering communication and decision making.

Conclusion

The EOL phase of HGG is substantially different from other patient groups, and more clinical studies in HGG on supportive medication, advance care planning and decision making are required. The organization of care, development of guidelines and interventions to decrease caregiver burden in the EOL phase are critical as well.

Keywords

End of life High-grade glioma Palliative care Caregiver burden End-of-life decision making 

Notes

Acknowledgments

The authors received funding from St. Jacobusstichting, The Hague, the Netherlands.

Conflict of interest

All authors have declared no conflicts of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Eefje M. Sizoo
    • 1
  • H. Roeline W. Pasman
    • 2
  • Linda Dirven
    • 1
  • Christine Marosi
    • 3
  • Wolfgang Grisold
    • 4
  • Günther Stockhammer
    • 5
  • Jonas Egeter
    • 6
  • Robin Grant
    • 7
  • Susan Chang
    • 8
  • Jan J. Heimans
    • 1
  • Luc Deliens
    • 2
    • 9
  • Jaap C. Reijneveld
    • 1
    • 10
  • Martin J. B. Taphoorn
    • 1
    • 11
    Email author
  1. 1.Department of NeurologyVU University Medical CenterAmsterdamThe Netherlands
  2. 2.Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, Expertise Center for Palliative CareVU University Medical CenterAmsterdamThe Netherlands
  3. 3.Department of Internal Medicine I, Clinical Division of Medical OncologyMedical University of ViennaViennaAustria
  4. 4.Department of NeurologyKaiser Franz Josef HospitalViennaAustria
  5. 5.Department of NeurologyInnsbruck Medical UniversityInnsbruckAustria
  6. 6.Department of Psychiatry and PsychotherapyInnsbruck Medical UniversityInnsbruckAustria
  7. 7.Edinburgh Centre for Neuro-OncologyWestern General HospitalEdinburghUK
  8. 8.Department of Neurological SurgeryUniversity of CaliforniaSan FranciscoUSA
  9. 9.End-of-Life Care Research GroupGhent University and Vrije Universiteit BrusselBrusselsBelgium
  10. 10.Department of NeurologyAcademic Medical Center AmsterdamAmsterdamThe Netherlands
  11. 11.Department of NeurologyMedical Center HaaglandenThe HagueThe Netherlands

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